To the Editor:
In truth, the image used by the authors of the letter shows new aspects of the dorsal fin of the fish, aspects that we could not see in the images that the lifeguard sent us. The fish seems to be the same, but the crucial aspects are not visualized in our images and the identification as Xiphias gladius was the most correct prior to the new image. An experienced Brazilian zoologist (ichthyologist) located in the Museum of Zoology, São Paulo University, made the initial identification of the fish. I appreciate the authors' comments, but the main aspect of the description (the attack of a “beak” fish in unusual circumstances) is not changed by this observation. Additionally, I find it strange that the possible new identification of the fish has not been sent directly to us, which would leave us very grateful and indebted to the authors. The direct response to the journal seemed to be most important for some unknown reason.
The text of the letter that questions the conditions of the attacks does not show consistency or experience of the authors with attacks or envenomation by fish. We obtained personal testimonials of the lifeguards who accompanied the first-aid care of the patient, as well as the medical annotations and testimony of the physicians who initially observed the patient—in 2 hospitals that provided care to the patient in both phases of the treatment (in the emergency room and after the surgery). The hospitals are cited in the text. This information resulted in similar statements that formed the basis for our conclusions. There is a serious flaw in the methodology of the text of the letter. The authors used only the testimony of the patient 2 years after the incident. The authors of the letter did not consider that the patient was in shock following the attack, and they, especially, did not consider the stress of the isolated animal in shallow water. We have no doubts about our conclusion, and the authors' conclusion is not supported by the data in their letter. Additionally, they do not suggest other mechanisms of attack, only question what was quoted.